Opioid-related deaths in St. Louis region continue to climb

Michelle Pattengill, a technician at L&S Pharmacy in Charleston, Mo., holds a bottle of oxycodone, a prescription opioid.

Bram Sable-Smith| Side Effects Public Media

The number of opioid-overdose deaths in St. Louis and surrounding counties continued to rise in 2017, although the increase wasn’t as steep as in previous years.

There were 760 opioid-related fatalities last year in St. Louis, St. Louis County and eight surrounding counties, a 7 percent increase from 2016, according to the St. Louis-based National Council on Alcoholism and Drug Dependence. The year before, the number of deaths jumped nearly 40 percent.

“We have seen a major increase in access to treatment, in access to naloxone, in access to harm-reduction strategies, and that might having an impact in slowing down the increase,” said Brandon Costerison, director of the addiction prevention and education initiative MO-HOPE.

But in the last decade, the region's overdose deaths have steadily climbed, with more people dying every year since 2012, Costerison said.

Costerison said health workers with limited resources have been focused on treatment and harm-reduction projects such as increasing the availability of the overdose-revival drug naloxone. To end the trend, they must focus on keeping people from becoming addicted to drugs to begin with, he said.

“We’re going to continue to see the numbers of people who develop substance-use disorder climb so long as prevention has not been prioritized,” Costerison said.

For example, MO-HOPE has been supporting initiatives to get parents involved in talking about addiction with their families, he said.

Unlike other agencies, NCADA looked at medical examiner data, which ties deaths to where a person died, and not where they lived. In addition to St. Louis and St. Louis County, it collected data from St. Charles, Jefferson, Lincoln, Warren and Franklin counties in Missouri and Madison and St. Clair counties in Illinois.

St. Charles County saw 80 opioid deaths in 2017 — up nearly 50 percent from the previous year, one of the largest increases in the region.

There were 606 recorded overdoses in St. Charles County in 2017, 54 more than the year before. But a larger portion were deadly, said Kyle Gaines, director of community relations at the St. Charles County Ambulance District.

“Obviously, as you have more overdoses in total, you’ll see more fatalities,” Gaines said.

“But the number of fatalities increased from a percentage standpoint quite a bit more.”

He said the increase in deaths is likely due to use of deadlier drugs.

“If I’m understanding things correctly, there was more fentanyl involvement in the ones that were fatal,” he said. “The synthetic opioids really skyrocketed.”

Synthetic opioids are man-made substances meant to mimic the use of other drugs such as heroin. They can more potent at much smaller doses.

Many drug users don’t know the amount of synthetics that are in the drugs they ingest and easily take a fatal amount. In 2016, the substances surpassed prescription opioids as the leading cause of opioid-related deaths, according to the federal National Institute on Drug Abuse.

Paramedics, firefighters and other emergency responders have long carried the opioid overdose reversal drug naloxone. But Missouri health officials also want to put it in the hands of as many laypeople as possible.

Thanks to a $5 million grant from the federal government, the Missouri Department of Mental Health is giving naloxone away through a project called MO-HOPE.

Last year, frustrated with a lack of commitment from state legislators, St. Louis County created its own prescription-drug monitoring program with the specific expectation other areas of the state could join in – and they have.